HHS Proposes Rule to Establish Disincentives for Health Care Providers that have Committed Information Blocking

HHS requests public comment by January 2, 2024

The U.S. Department of Health and Human Services (HHS) today released a proposed rule for public comment that would establish disincentives for healthcare providers found by the HHS Office of Inspector General (OIG) to have committed information blocking – when a provider knowingly and unreasonably interferes with the access, exchange, or use of electronic health information except as required by law or covered by a regulatory exception. The proposed rule, which reflects contributions from throughout the department, implements the HHS Secretary’s authority under section 4004 of the 21st Century Cures Act (Cures Act).

The proposed rule released today complements OIG’s rule that established information-blocking penalties for the other actors identified by Congress (health information technology (IT) developers of certified health IT or other entities offering certified health IT, health information exchanges, and health information networks).

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The New Board would recognize the evolution of cardiology into a distinct medical specialty.

Washington (September 21, 2023)— Many of the nation’s most prominent cardiovascular organizations, representing tens of thousands of physicians, unite today to pursue the creation of a new Board for cardiovascular medicine. The proposed new Board would be independent of the American Board of Internal Medicine, where the cardiology certification process currently exists. Collectively, the American College of Cardiology (ACC), Heart Failure Society of America (HFSA), Heart Rhythm Society (HRS), and Society for Cardiovascular Angiography & Interventions (SCAI) are working together to submit a new Board application, with the potential for additional consortium members to join.

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On September 1, 2023, the Centers for Medicare & Medicaid Services (CMS) issued the Minimum Staffing Standards for Long-Term Care (LTC) Facilities and Medicaid Institutional Payment Transparency Reporting proposed rule, which seeks to establish comprehensive nurse staffing requirements to hold nursing homes accountable for providing safe and high-quality care for the over 1.2 million residents receiving care in Medicare and Medicaid-certified LTC facilities each day.

Ensuring that beneficiaries receive safe, reliable, and quality nursing home care is a critical function of the Medicare and Medicaid programs and a top priority of CMS. The COVID-19 Public Health Emergency (PHE) tragically caused unprecedented illness and death among nursing home residents and workers. The PHE also exacerbated staffing challenges experienced in many facilities and further highlighted disparities in care and outcomes. Despite existing requirements that facilities provide sufficient levels of staffing in LTC facilities, chronic understaffing remains a significant concern.

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Cigna Healthcare Removes 25 Percent of Medical Services From Prior Authorization, Simplifying the Care Experience for Customers and Clinicians

Latest Removal Represents an Additional 600+ Medical Services

BLOOMFIELD, Conn., Aug. 24, 2023 /PRNewswireThis link will open in a new tab./ — Cigna Healthcare, the health benefits provider of The Cigna Group (NYSE: CI), announced the removal of nearly 25 percent of medical services from prior authorization (or precertification) requirements. With the removal of these more than 600 additional codes, the company has now removed prior authorization on more than 1,100 medical services since 2020, with the goal of simplifying the health care experience for both customers and clinicians.

“Our goal is to help keep patients safe, improve health outcomes, and make care more affordable, and this important step will enable us to do that while removing administrative burdens on the health care system,” said David Brailer, MD, executive vice president and Chief Health Officer, The Cigna Group. “We’ve listened attentively to our clinician partners and are deliberately making these changes as a result. We will continue to hold ourselves accountable for this important work and look forward to building on this momentum in the future.”

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Medicare Updated Telehealth Factsheet

Recently, the Centers for Medicare and Medicaid Services (CMS) updated and released their Medicare Learning Network (MLN) factsheet on Telehealth Services. Pre-COVID, CMS published an updated Telehealth Factsheet annually, although throughout the course of COVID the factsheet had been updated less frequently as temporary policy changes made it difficult to keep pace. Earlier this year, the factsheet was taken down and had been listed as unavailable on the CMS website for the past few months. Presumably, CMS was working to update it with the most recent telehealth policy changes given the extension of many of the COVID telehealth flexibilities until December 31, 2024 due to the passage of the Consolidated Appropriations Act, 2023. Some key clarifications made in the updated factsheet include:

Through December 31, 2024, all patients can get telehealth wherever they’re located. They don’t need to be at a specific type of originating site, and there aren’t any geographic restrictions.
After December 31, 2024:
- For non-behavioral or mental telehealth, there may be originating site requirements and geographic location restrictions
- For behavioral or mental telehealth, all patients can continue to get telehealth wherever they’re located, with no originating site requirements or geographic location restrictions if certain conditions are met
Through December 31, 2024, all providers who are eligible to bill Medicare for professional services can provide distant site telehealth.
Providers can use audio-only telehealth for some non-behavioral or mental telehealth through December 31, 2024.
CMS requires patient consent for all care management and virtual communication services, including non-face-to-face services. Consent can be obtained at the same time a provider initially provides the services. The person getting consent can be an employee, independent contractor, or leased employee of the billing practitioner.
Starting July 1, 2023, providers must report the use of telehealth technology (see factsheet for G-Codes) in providing home health (HH) services on HH payment claims.
Through December 31, 2024:
- Telehealth can be used to conduct hospice care eligibility recertification
- For behavioral or mental telehealth, providers don’t have to conduct an in-person visit within 6 months of the initial telehealth visit or annually thereafter
- CMS has extended the Acute Hospital Care at Home Program.

In addition to adding the information above, CMS also made significant deletions from the previous version of their factsheet, including the permanent eligible originating site list, explanation of the requirement for patients to be located in rural areas and the permanent distant site provider list. In this current version, CMS merely mentions in one bullet point that originating site requirements and geographic restrictions for non-behavioral or mental telehealth ‘may’ go back into effect after Dec. 31, 2024. This was likely done for the sake of clarity so as not to confuse providers between current reimbursement policy (effective for the most part until December 31, 2024) and permanent policy (which will go into effect on Jan. 1, 2025). It could also indicate an expectation that permanent policy (which is in statute) could potentially be amended before Jan. 1, 2025. For more on current Medicare telehealth policy, see the MLN Telehealth Services Factsheet.